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Sheared Heel and Contraction
Although the owner of this horse had been trimming him, progress decontracting was slow and he developed a sheared heel which could have come from owner trimming errors. I took him for a few months and with rehab walking on a rubber track and trimming every few days, he made good progress in decontraction and I was able to fix his sheared heel.
Decontracting in progress
Although this photo is not straight, you can see that the butt crack has started to open up and abscessing is occuring in the frog. Really look at the black coloration below the skin of the bulbs. That necrotic tissue extends deeply into the digital cushion (remember the frost bitten fingers?) All of this dead material takes time for the body to abscess out. Bruising of the sole and various parts of the hoof horn are bound to happen as the hoof capsule stretches. It gets ugly before it gets pretty!
Starting to open and straighten
The "butt crack" is starting to open. Abscessing in the frog was inevitable as contraction had caused much necrosis (death) of frog tissue and the digital cushion. It takes a long time to get this kind of hoof to come back from the pathology that was present. The key to getting this foot opened up was lots of soaking, walking on rubber paved track, and frequent trimming of bar and displaced heels.
How to have an x-ray done
When you have an x-ray done of your horse's feet (which I highly recommend!) be sure to tape a wire to the hairline and a horseshoe nail or wire to the front toe wall. You can tape a penny or put a shallow thumbtack at the tip of the frog too. Be sure to pick up the opposite foot so that the one x-rayed is fully weight-bearing and that the camera is perpendicular to the lateral wall. These landmarks will help the trimmer determine several things. First, the position of the coffin bone inside the hoof capsule. If you look at my founder cases, you will see how the toe wall diverges from the coffin bone. The wire will show how high up within the hoof capsule the coffin bone is positioned. The extensor process should be level with the wire which indicates the hairline. If the coffin bone were tipped forward, the heels would need more trimming. If the toe wall diverged, the toe may need backing up. If the coffin bone has dropped within the hoof capsule as it does in a founder case, but still ground parallel, the bars would need to be trimmed down and the horse would need to wear hoof boots with pads. Ideally, the hairline should measure at an angle of 30 degrees and the toe/coronet angle should measure approximately 100 degrees (95 for hinds and 105 for fronts is the absolute ideal but I feel 100 degrees for the front is acceptable. What you DON'T want is a toe/coronet angle that is greater than 105 degrees. That would indicate toe wall separation.) You also want to look at the dorsal profile of the coffin bone. Either convexity or concavity of the dorsal hoof wall means there is [possible coffin bone loss. The profile should be straight.
Toe-in, contraction and heel shear in this draft Quarter horse
This horse has a diagnosed lameness grade one in the left front. I assessed his gait and stance and easily determined that his problems were a result of high heels, high bars and medial/lateral imbalances. The vet had looked for problems higher up in the fetlock as the horse has ringbone seen on x-ray. Ringbone is not the problem! It is the result of the problem! The obvious imbalances in the foot are the problem!
LF of the above horse showing medial/lateral imbalance, high heels and bars, and contraction
This horse was walking on his toes with very stiff gait. He was standing with his left front leg in a relief posture ("buck-kneed") See photo below.
If you look at the hairline in this photo you will see that the outer wall (on your right) is shorter than the inner wall. This is heel shear where one side of the heel is pushed up higher than the other. The horse puts more weight on the outside heel. This is usually a result of evading a painfully high bar on the inside. Since most bars are straighter on the inside they usually push up higher into the interior of the hoof causing pain and possible damage to the flexor tendon and navicular bursa. Since the flexor tendon, digital arteries and navicular bursa are all above the bars, they have the potential for damage if this condition is not remedied by a proper corrective trim and conscientious rehabilitation. With the high heels, the digital arteries, that join and become the transverse arch inside the coffin bone, are pinched shut. This causes the laminar corium in the front of the hoof to become deprived of blood. The pressure on the laminar horn at this angle also causes damage, which results in a loss of suspension. As circulation returns in the next few weeks, the laminar corium that was damaged will experience inflammation and abscessing as the hoof "house cleans". A new attachment must grow in to re-suspend the coffin bone. Also, the frog corium is cut off from blood supply.
If you look at the hairline in this photo you will see that the outer wall (on your right) is shorter than the inner wall. This is heel shear where one side of the heel is pushed up higher than the other. The horse puts more weight on the outside heel. This is usually a result of evading a painfully high bar on the inside. Since most bars are straighter on the inside they usually push up higher into the interior of the hoof causing pain and possible damage to the flexor tendon and navicular bursa. Since the flexor tendon, digital arteries and navicular bursa are all above the bars, they have the potential for damage if this condition is not remedied by a proper corrective trim and conscientious rehabilitation. With the high heels, the digital arteries, that join and become the transverse arch inside the coffin bone, are pinched shut. This causes the laminar corium in the front of the hoof to become deprived of blood. The pressure on the laminar horn at this angle also causes damage, which results in a loss of suspension. As circulation returns in the next few weeks, the laminar corium that was damaged will experience inflammation and abscessing as the hoof "house cleans". A new attachment must grow in to re-suspend the coffin bone. Also, the frog corium is cut off from blood supply.
Note relief posture (knee slightly bent to relieve heel pain) in left front before trim.
Bulb view of LF after trim
This is a bulb view of the left front after trimming so from your view, the outside lateral wall is on your right. To correct the heel shear in the foot, I trimmed the inside lateral wall and heel slightly more. If you compare the lateral wall lengths you will see that they are very close to the same length. Note the darkened skin tissue below the central sulcus. That is indicative of necrotic tissue within the digital cushion. This will be abscessed out through the frog. I trimmed opening cuts (displaced heel), bar and lateral walls as well as smoothing the sole to the dirt line. The toe needed very little rasping as it had been worn down due to being frontally loaded. Feet like this are like the fingers in the photo I had on my Hoof Trimming page showing frost bitten fingers.
LF Lateral Before trim
You can clearly see the very upright stance of the horse (62 degree toe angle) The point of impact of the heel is aligned directly below the navicular bone. No wonder this horse was landing toe first! The hairline angle is less than 20 degrees which indicates a coffin bone that is tipped forward. And since the owner provided me with a copy of her horse's x-rays of this foot, I could see that indeed that was the case.
LF after trim
After the trim you can see the better angles (48 degree toe angle and approx. 28 degree hairline) The horse ran around all night in a new environment which may have helped to open this contracted foot up. But due to the damage from high heels and bars, I suspect he will have some inflamation in the lamina. I always look at my after photos and wish I had taken more heel! This one I wish I had trimmed about 1/8" more heel to bring it closer to 30 degrees.
LF sole view Before trim
As you can see in this sole view, the outside wall (your left) is more flared than the inside wall. The outside bar has more pooling and more angle than the straighter inside bar. Since we know that the horse is pigeon-toed, we can assume it is caused by evading pain from this inside bar. The greater weight put on the outside half of the foot has caused more flaring of the wall there. This foot has significant contraction too. I lament the fact that to me this simple and obvious problem is completely unseen by the veterinarian and she then looks for problems higher up in the fetlock and pastern and recommends orthopedic shoes!
LF sole view After trim
After the trim you can see that I took the bars down, (although they could be taken down even more as they are very impacted), and trimmed the frog so you could see the darkened tissue below the surface. That is DEAD from the pinching of contraction and high bars! This is a white foot with what should be a white frog. We hope to see the frog come back to life as the heels open up and let good nourishing blood into necrotic digital cushion tissue! There will be abscessing! And that's a good thing! Hoof house cleaning!
Frontal view of Left Front confirms that the inside (medial) wall is straighter and shorter
This is the LF before the trim. As you can see, a small but significant crack is beginning to form at the toe. This is from being frontally weighted. I trim to have a ground parallel coffin bone which distributes the weight evenly around the hoof wall and frog. This foot does have walls that diverge and that is what will help him to de-contract..
TB with tendon bow LF
BEFORE trim
This 4 yr old TB mare off the track for a bowed tendon really had problems with her feet! A study was done on TBs with short heads and necks that stated that these horses would likely have a club foot. With this mare, it is very true. Her short head and neck predisposed her to develop a very contracted high-heeled foot on the right front from getting in the habit of always putting the left foot forward and the right one back. Consequently, she got a flat under-run foot on the left. With the stress of race training and shoeing, this difference in hoof shape caused a career-ending soft tissue injury, a bowed tendon... OR was it the foot???
Although the tendon seems serious, the problem is with the feet! In the BEFORE photo, you can see her stance with her front feet behind the vertical and hind feet ahead. Compare it to the AFTER one below which shows her afterwards with a relaxed stance, shoulders no longer bunched and tight and hips no longer tucked under, with straight legs after her trim.
Although the tendon seems serious, the problem is with the feet! In the BEFORE photo, you can see her stance with her front feet behind the vertical and hind feet ahead. Compare it to the AFTER one below which shows her afterwards with a relaxed stance, shoulders no longer bunched and tight and hips no longer tucked under, with straight legs after her trim.
AFTER 1st trim
The TRUTH about "bowed tendons"...
This Thanksgiving, before you cook your turkey, do a dissection of some turkey tendons in the leg. (by the way, tendons connect muscle to bone; ligaments connect bone to bone.)
"Bowed tendon" is considered a common injury in horses. However, it is very UNlikely that the tendon itself is injured. What is seen and called a "bowed tendon" is the fluid which the body sends into the tendon sheath to protect the tendon. The tendon is only very rarely damaged.
In this horse's case, the swelling in the leg was most likely due to the abscess in the left front foot. When you understand that the difference in the two feet would be like running around with a stilleto-heeled shoe on one foot and one of those flat Earth shoes on the other, its easy to see how damage could be done.
There is an old saying in veterinary medicine that I think most vets forget. That is: "Always suspect the foot!" In most cases, it is a foot problem that is causing lameness!
"Bowed tendon" is considered a common injury in horses. However, it is very UNlikely that the tendon itself is injured. What is seen and called a "bowed tendon" is the fluid which the body sends into the tendon sheath to protect the tendon. The tendon is only very rarely damaged.
In this horse's case, the swelling in the leg was most likely due to the abscess in the left front foot. When you understand that the difference in the two feet would be like running around with a stilleto-heeled shoe on one foot and one of those flat Earth shoes on the other, its easy to see how damage could be done.
There is an old saying in veterinary medicine that I think most vets forget. That is: "Always suspect the foot!" In most cases, it is a foot problem that is causing lameness!
LF loss of suspension, coffin bone protrusion abscess, under-run heels, long bars
Left front before trim
When I tell people that a horse would rather walk.on it's coffin bone coming thru the sole than weight the bars, this is an example! The bars are very long and due to the under-run heels which jack them up into the tender area under the navicular bone, The horse chooses to put it's weight on the toe. Eventually, with a loss of laminar connection, the coffin bone comes right thru the sole. In this case, the abscess at what should be the toe callous is what we see from the bottom. Look at the lateral view to see how the top half of the toe wall is convex from the coffin bone being tipped forward while the bottom half of the toe wall is stretched and separated. Due to the long bars and under-run heels, the lateral wall is separated from the inside of the foot structures.
Left front Lateral view BEFORE trim
LF sole after trim
LF after trim
I trimmed the bars, pulled the heels back and rasped the flared wall. With the horse more comfortable in it's heels, it will take the weight off the front half of the foot allowing the coffin bone to resuspend itself by growing in a new laminar attachment.
The lateral view of this foot below shows that I rasped the flared wall off and you can see old abscess exits from the weakened attachment. All the white area is the sub-layers of horn. This foot is very comparable to the under-run TB gelding I have. Note the hairline curve near the bulb of the heel where the under-run heel dragged it down.
The lateral view of this foot below shows that I rasped the flared wall off and you can see old abscess exits from the weakened attachment. All the white area is the sub-layers of horn. This foot is very comparable to the under-run TB gelding I have. Note the hairline curve near the bulb of the heel where the under-run heel dragged it down.
Left front lateral AFTER
After 4 1/2 weeks
The amount of horn growth is said to be normally about one forth inch every 4 weeks. But surprisingly, this wall grew an amazing 1/2 inch in a little over 4 weeks! This proves the fact that injured tissue grows faster than normal healthy tissue. The body tries to repair itself as quickly as possible. The abscess exit on the lateral wall makes it easy to measure wall growth.
Right front is the clubbed one
Same horse, two different feet; also called "high/low" one contracted and upright, the other one flat. Think about this, the contracted high-heeled one formed over time when the foal reached down for his grass and couldn't make it with that short head and neck, so he put one foot forward and one foot back and that became the habit. Through the early training when shoes were applied, the foot was kept in this deformed state. The left flatter foot received an unnatural amount of weight, It is the one that eventually failed and sustained injury. But if the feet had been trimmed to correct the imbalance when the foal was growing, this injury would probably never have happened. Compare this bulb view of the right more contracted foot with the left one below. Both are contracted but the right is worse.
Left front bulb view Before trim
Left Front bulb view After trim
Sorry about the flash as we were in the barn but you can still see how much I took the heels and bars down.
Right Front bulb view After trim
Comparing the Left front to the Right, you can see the contracted heel in the right. But look at the After photo below of the dorsal view and see how even these two very different hooves can look more alike after a good trim. There is still alot of healing to be done but by decontracting the more contracted foot and helping the left flatter foot to regain its health, this horse should be on its way to recovering.
RF sole view after trim
RF after trim
After being trimmed, this right front foot doesn't look so bad. I have a feeling that once the left front has better suspension and attachment and once this foot opens up, they won't look so different.
Compare RF to LF Before trimming
This is a very dramatic photo showing the difference in the two feet prior to the first corrective trim. You can clearly see that the right front is very much higher heeled than the left front which is under-run.
4 and 1/2 weeks after first trim
Since we know this horse was standing on her toe, we can assume there has been some coffin bone remodeling in this foot. It is more contracted and likely the tip has had some loss of bone due to pressure. But this photo shows a much better angle for the foot.
Dorsal view of fronts after 1st trim
Dorsal view of both fronts after 2nd trim